Nurses represent the single largest group of health professionals that delivers hospital care, yet little is known about what nurses do within a system context to ensure that care is safe, beneficial, patient-centered, timely, efficient and equitable. Quality improvement and patient safety in healthcare are national priorities;yet insufficient progress has been made in quality improvement science, particularly focusing on nursing care processes in the hospital setting. The broad goal of this project is to create a new large-scale nursing-focused practice-based research network (PBRN- RN) and support center for the purpose of accelerating interprofessional improvement science in a systems context. The proposed PBRN-RN will fill a national gap by creating an infrastructure hub for improvement and science. Our 2-year project will leverage existing infrastructure to establish a sustainable PBRN-RN for nursing care research within acute healthcare organizations. Our specific aims are as follows: 1. Design a PBRN-RN that reflects best practices in PBRNs (Durako, 2006;Green et al., 2005) and capitalizes on synergies among the PBRN-RN coordinating center team, the PBRN-RN Steering Council and membership, the UTHSC IIMS, and Westat, Inc., to achieve economies of scale and shared learning. 2. Recruit and engage key members from leading clinical and academic settings to be members of an effective national research network that collaborates to generate improvement science to guide practice. 3. Launch a relevant, rigorous, and robust PBRN-RN program of research studies to improve patient care within microsystem and system contexts and across multiple hospital sites. 4. Establish PBRN-RN coordinating center resources and structures that enhance ability of clinical and academic researcher PBRN-RN members to conduct and disseminate rigorous improvement research studies across multiple settings. 5. Design a web based electronic technology infrastructure that supports the conduct of improvement research studies and affords efficiency and accuracy for collecting, storing, processing, using, and communicating data and information. 6. Evaluate the essential network features, including governance and policies, staff support, communication, and effectiveness of multi-site study support. PUBLIC HEALTH RELEVANCE: Quality improvement and patient safety in healthcare are high priorities held by the federal government, accrediting bodies, regulatory agencies, and patient-advocacy groups;yet insufficient progress has been made in knowing how to improve effectiveness and safety, specifically focused on hospital nursing care. The broad goal of this project is to expand a national practice-based research network (the PBRN-RN) and build a new large-scale coordinating center that will accelerate hospital-based nursing studies, showing us how to make care safe and effective.